Executive Summary

This analysis examines nutrition education practices across 55 dental schools worldwide after removing duplicate entries. The survey reveals significant insights into current integration methods, teaching approaches, research activities, and regional variations in nutrition education delivery within dental curricula.

Metric Value
Participating Schools 55
Integration Rate 61%
Average Hours 25
Collaboration Interest 91%
Research Activity 60%

1. Global Analysis (All 55 Schools)

1.1 Curriculum Structure & Content

Q2: Integration Methods

Integration Method Count Percentage (%)
Integrated throughout multiple courses 33 61
Standalone nutrition course 8 15
Not formally included 7 13
Both standalone and integrated approaches 6 11

Key Finding

61% of schools integrate nutrition throughout multiple courses, representing the most popular approach. Only 13% of schools do not formally include nutrition education.

Q3:Hours Distribution

Global: Nutrition Education Hours Statistics
Statistic Value
Count 45
Mean 26
Median 15
Min 2
Max 150
Q1 10
Q3 34
SD 28

Q4: Academic Years When Nutrition Education is Provided

Global: Academic Years When Nutrition Education is Provided
Academic Year Count Percentage of Schools (%)
Second year 37 67.3
Third year 35 63.6
First year 29 52.7
Fourth year 17 30.9
Fifth year 5 9.1
Sixth year 4 7.3

Key Finding

Second year (67.3%) and Third year (63.6%) are the most common years for nutrition education delivery, with many schools providing education across multiple years of the curriculum.

Q5: Detailed Curriculum Topic Coverage

Global: Detailed Curriculum Topic Coverage Analysis (3-Point Scale)
Nutrition Topic Not Covered (%) Moderately (%) Adequately (%) Total Covered (%) Quality Assessment
Diet and dental caries 2 19 79 98 High Quality
Dental erosion and eating disorders 8 38 55 93 Good Coverage
Basic nutrition principles and metabolism 9 40 51 91 Good Coverage
Public health nutrition 9 38 53 91 Good Coverage
Nutrition in periodontal health 17 35 48 83 Good Coverage
Dietary assessment methods 19 37 44 81 Good Coverage
Nutrition counseling techniques 21 43 36 79 Good Coverage
Diet-related systemic diseases 22 50 28 78 Good Coverage
Special populations nutrition 26 57 17 74 Moderate Coverage

Q6: Teaching Methods

Global: Teaching Methods Used in Nutrition Education
Teaching Method Count Percentage of Schools (%)
Lectures 52 94.5
Case-based learning 37 67.3
Clinical observations 20 36.4
Problem-based learning 20 36.4
One-to-one patient advice and support 19 34.5
Simulation exercises 14 25.5
Online modules 6 10.9
Other (please specify) 4 7.3

Q7: Practical Learning Exercises

Global: Required Practical Exercises in Nutrition Education
Practical Exercise Schools Percentage (%)
Collection and interpretation of dietary records 29 53
Nutritional analysis software usage 9 16
Patient education and dietary change support 36 65

1.2 Research Activities

Q10: Research Activity

Global: Schools Conducting Nutrition-Related Research
Conducts Research Count Percentage (%)
Yes 32 60.4
No 21 39.6

Q11: Research Areas and Details

Global: Nutrition Research Areas (Among Research-Active Schools)
Research Area Count Percentage (%)
Public health nutrition 22 40.0
Clinical nutrition studies 20 36.4
Behavioral research 12 21.8
Basic science research 9 16.4
Other (please specify) 2 3.6

Q12: Student Research Participation

Global: Student Research Participation Levels
Student Participation Level Count Percentage (%)
0 19 35.8
5 9 17.0
1 8 15.1
10 7 13.2
2 4 7.5
0.5 2 3.8
15 1 1.9
20 1 1.9
50 1 1.9
70 1 1.9

Key Finding

40% of schools report no student research participation, representing a significant opportunity to enhance student engagement with nutrition research. Among schools with student involvement, 1-10% participation is most common (27% of schools).

1.3 Assessment & Quality

Q13: Assessment Methods Analysis

Global: Assessment Methods Used in Nutrition Education
Assessment Method Count Percentage (%)
Written exams 46 83.6
Case presentations 23 41.8
Clinical assessments 23 41.8
Research projects 12 21.8
OSCE stations 11 20.0
Other (please specify) 5 9.1

Q16: Program Quality Self-Assessment

Global: Program Quality Self-Assessment (5-Point Likert Scale Analysis)
Quality Statement Strongly Agree (%) Total Agreement (%) Agreement Strength
Current curriculum time is sufficient 3.8 73.0 Moderate
Research integration enhances education 5.8 69.3 Moderate
Adequately prepares students for clinical practice 11.5 67.3 Moderate
Students demonstrate competency in dietary advice 11.5 61.5 Moderate

1.4 Collaboration & Resources

Q8: Interprofessional Collaboration

Global: Healthcare Professionals Involved in Nutrition Education
Healthcare Professional Count Percentage (%)
Dental/hygiene therapists/dentists 42 76.4
Medical doctor/Physician Assistant 19 34.5
Nutritionist 13 23.6
Registered Dietitian 12 21.8
Other (please specify) 6 10.9
Social worker/psychologist 5 9.1
Pharmacist 3 5.5
General Nurses/Nurse Practitioners 1 1.8

Q9: Interprofessional Activities

Global: Types of Interprofessional Activities
Interprofessional Activity Count Percentage (%)
Joint lectures/seminars 26 47.3
Research collaboration 20 36.4
None 15 27.3
Shared clinical rotations 11 20.0
Case conferences 8 14.5
Other (please specify) 2 3.6

Q14: Current Nutrition Education Resources Available

Global: Nutrition Education Resources Currently Available
Currently Available Resource Count Percentage (%)
Online resources 41 74.5
Textbooks 41 74.5
Patient education materials 27 49.1
Clinical guidelines 26 47.3
Key/systematic literature reviews 26 47.3
Interdisciplinary expertise 21 38.2
Dedicated nutrition faculty 10 18.2

Q17: Desired Improvements for Nutrition Programs

Global: Desired Improvements for Nutrition Education Programs
Desired Improvement Count Percentage (%)
More clinical integration 34 61.8
Increased curriculum space 30 54.5
Additional clinical faculty training 26 47.3
Enhanced resources 22 40.0
Improved assessment methods 12 21.8
More online nutrition courses 12 21.8
Other (please specify) 4 7.3

Q20: Multi-institutional Collaboration Interest

Global: Interest in Multi-institutional Collaboration
Collaboration Interest Count Percentage (%)
Yes 48 90.6
No 5 9.4

1.5 Implementation Challenges & Future Plans

Q18: Implementation Barriers

Global: Main Barriers to Providing Nutrition Education
Barrier Count Percentage of Schools (%)
Limited curriculum time 41 74.5
Low priority in curriculum 22 40.0
Lack of faculty expertise 18 32.7
Limited resources 14 25.5
Other (please specify) 5 9.1

Q19: Future Plans

Global: Plans to Modify Curriculum
Future Plans (Next 2 Years) Count Percentage (%)
No 20 37.7
Yes (please describe) 17 32.1
Unsure 16 30.2

1.6 Global Analysis: Key Findings Summary

Enhanced summary statistics for key findings

Enhanced Global Summary Statistics
Metric Value
Total Schools 55
Integration Rate 61.1%
Avg Hours 24.6
Research Active 60.4%
Collaboration Interest 90.6%

Integration & Delivery

61% Multi-Course Integration: Integrated delivery throughout multiple courses dominates, with only 13% using standalone courses.

Years 2-3 Peak Delivery: Second (67%) and Third (64%) years concentrate nutrition education during clinical readiness development.

26.2 Hours Average Allocation: Wide range (2-150 hours) indicates significant variation in commitment levels.

95% Lecture Dependency: Traditional teaching methods dominate, with case-based learning (67%) as primary active method.

Topic Coverage vs. Quality Gap (Major Finding)

Near-Universal Basic Coverage: Diet & caries (98%) and basic principles (95%) show excellent coverage rates.

2. Regional Analysis by Geographic Region

This section examines nutrition education practices across the three major geographic regions represented in our survey: Europe, North America, and Other Regions. Regional analysis reveals distinct patterns in curriculum delivery, research activities, and collaboration approaches that reflect different educational systems, resource availability, and institutional priorities.

The regional comparison provides insights into:

  • Integration method preferences by geographic context
  • Resource allocation patterns across different educational systems
  • Research activity levels and focus areas by region
  • Collaboration opportunities and partnership potential
  • Implementation challenges specific to regional contexts

2.1 Participating Schools by Region

Regional Characteristics Overview

Europe (24 schools, 43.6%): Includes institutions from UK, Eastern Europe, Western Europe, Nordic countries, Spain, Ireland, and Cyprus. Strong representation across diverse European dental education systems.

North America (13 schools, 23.6%): Covers United States and Canadian institutions with established dental programs and strong research infrastructure.

Other Regions (18 schools, 32.7%): Represents emerging dental education programs and institutions from diverse global contexts, including unnamed institutions and schools from developing dental education markets.

Note: Minor differences exist in some regional percentages in this report relative to the submitted manuscript, reflecting small differences in regional n values following post-hoc correction of institutional assignments. The submitted values (Europe n=25, North America n=13, Other Regions n=17) are correct hard coded in Rmd file: ejde_results_streamlined_REVISED.Rmd

Q2: Integration Methods by Region

Regional Comparison: Integration Methods (Percentage by Region)
nutrition_integration_method Europe North America Other Regions
Both standalone and integrated approaches 8.3 15.4 11.8
Integrated throughout multiple courses 66.7 69.2 47.1
Not formally included 8.3 0.0 29.4
Standalone nutrition course 16.7 15.4 11.8

Q3: Hours Analysis by Region

Regional Comparison: Hours Dedicated to Nutrition Education
Region N Mean Median Min Max SD
Other Regions 10 41.8 12.5 4 150 49.4
Europe 23 25.8 20.0 2 72 19.9
North America 12 14.0 12.0 4 28 6.8

Q4: Academic Years by Region

Regional Comparison: Academic Years When Nutrition Education is Provided (% of schools)
education_years_provided Europe North America Other Regions
Fifth year 16.7 0.0 5.6
First year 66.7 76.9 16.7
Fourth year 37.5 30.8 22.2
Second year 70.8 84.6 50.0
Sixth year 16.7 0.0 0.0
Third year 66.7 76.9 50.0
## Q5: Topic Coverage by Region
Regional Comparison: Topic Coverage (% Total Covered / % Adequately Covered)
Europe
North America
Other Regions
Topic Total_Covered_Europe Total_Covered_North America Total_Covered_Other Regions Adequately_Covered_Europe Adequately_Covered_North America Adequately_Covered_Other Regions
Diet and dental caries 100 100 94 96 77 59
Nutrition in periodontal health 82 100 72 52 46 44
Public health nutrition 95 100 76 65 54 35
Dietary assessment methods 92 92 61 57 54 22
Nutrition counseling techniques 95 92 50 45 46 17
Diet-related systemic diseases 78 92 67 39 23 17
Dental erosion and eating disorders 100 85 88 70 62 29
Basic nutrition principles and metabolism 100 84 82 65 46 35
Special populations nutrition 83 69 65 26 15 6

Q6: Teaching Methods by Region

Regional Comparison: Top Teaching Methods (% of schools using each method)
teaching_methods Europe North America Other Regions
Case-based learning 75.0 76.9 50.0
Clinical observations 50.0 30.8 22.2
Lectures 95.8 100.0 88.9
One-to-one patient advice and support 37.5 46.2 22.2
Problem-based learning 45.8 53.8 11.1
Simulation exercises 33.3 30.8 11.1

Q13: Assessment Methods by Region

Regional Comparison: Top Assessment Methods (% of schools using each method)
competency_assessment Europe North America Other Regions
Case presentations 54.2 38.5 27.8
Clinical assessments 45.8 53.8 27.8
OSCE stations 20.8 23.1 16.7
Research projects 25.0 15.4 22.2
Written exams 87.5 92.3 72.2

Q7: Practical Exercises by Region

Regional Comparison: Required Practical Exercises (% of schools requiring each)
Practical Exercise Europe (%) North America (%) Other Regions (%)
Dietary Records Collection 66.7 61.5 27.8
Nutrition Software Usage 20.8 23.1 5.6
Patient Education Support 75.0 69.2 50.0

Q8: Healthcare Professionals by Region

Regional Comparison: Top Healthcare Professionals (% of schools involving each)
healthcare_professionals Europe North America Other Regions
Dental/hygiene therapists/dentists 87.5 76.9 61.1
Medical doctor/Physician Assistant 58.3 7.7 22.2
Nutritionist 25.0 15.4 27.8
Other (please specify) 8.3 7.7 16.7
Registered Dietitian 25.0 38.5 5.6
Social worker/psychologist 12.5 15.4 0.0

Q9: Interprofessional Activities by Region

Regional Comparison: Top Interprofessional Activities (% of schools conducting each)
interprofessional_activities Europe North America Other Regions
Case conferences 12.5 15.4 16.7
Joint lectures/seminars 41.7 38.5 61.1
None 25.0 46.2 16.7
Research collaboration 45.8 30.8 27.8
Shared clinical rotations 20.8 23.1 16.7

Q10: Research Activity by Region

Regional Comparison: Research Activity (Percentage by Region)
nutrition_research_conducted Europe North America Other Regions
No 30.4 46.2 47.1
Yes 69.6 53.8 52.9

Q11: Research Areas by Region

Regional Comparison: Top Research Areas (% of schools)
research_areas Europe North America Other Regions
Basic science research 16.7 23.1 11.1
Behavioral research 25.0 15.4 22.2
Clinical nutrition studies 41.7 23.1 38.9
Public health nutrition 45.8 30.8 38.9
Other (please specify) 0.0 7.7 5.6

Q12: Student Research Participation by Region

Regional Comparison: Student Research Participation Levels (% of schools)
student_research_percentage Europe North America Other Regions
0 34.8 30.8 41.2
0.5 4.3 7.7 0.0
1 4.3 38.5 11.8
10 21.7 7.7 5.9
2 4.3 7.7 11.8
20 4.3 0.0 0.0
5 26.1 0.0 17.6
15 0.0 7.7 0.0
50 0.0 0.0 5.9
70 0.0 0.0 5.9

Q17: Desired Improvements by Region

Regional Comparison: Desired Program Improvements (% of schools requesting)
improvement_suggestions Europe North America Other Regions
Additional clinical faculty training 41.7 61.5 44.4
Enhanced resources 50.0 46.2 22.2
Improved assessment methods 20.8 7.7 33.3
Increased curriculum space 45.8 53.8 66.7
More clinical integration 70.8 53.8 55.6
More online nutrition courses 16.7 15.4 33.3

Q14: Current Resources by Region

Regional Comparison: Current Resources Available (% of schools currently using)
available_resources Europe North America Other Regions
Clinical guidelines 58.3 46.2 33.3
Dedicated nutrition faculty 20.8 23.1 11.1
Interdisciplinary expertise 41.7 46.2 27.8
Key/systematic literature reviews 54.2 53.8 33.3
Online resources 79.2 76.9 66.7
Patient education materials 62.5 61.5 22.2
Textbooks 87.5 69.2 61.1

Q15: Implementation Barriers by Region (CORRECTED - was incomplete)

Regional Comparison: Top Implementation Barriers (% of schools reporting)
education_barriers Europe North America Other Regions
Lack of faculty expertise 29.2 30.8 38.9
Limited curriculum time 75.0 84.6 66.7
Limited resources 29.2 30.8 16.7
Low priority in curriculum 29.2 46.2 50.0
Other (please specify) 8.3 15.4 5.6

Q16: Program Quality Assessment by Region (DETAILED - FIXED)

## 
## ### Regional Quality Assessment Summary:
Regional Summary: Average Agreement Rates Across All Quality Metrics
Region Avg Total Agreement (%) Avg Strong Agreement (%) Total Responses
Europe 70.6 7.6 92
North America 61.6 13.5 52
Other Regions 68.7 4.7 64

Q20: Collaboration Interest by Region

Regional Comparison: Collaboration Interest (Percentage by Region)
followup_survey_willingness Europe North America Other Regions
No 8.7 7.7 11.8
Yes 91.3 92.3 88.2

Q19: Future Plans by Region

Regional Comparison: Future Curriculum Modification Plans (% of schools)
future_modification_plans Europe North America Other Regions
No 39.1 53.8 23.5
Unsure 30.4 15.4 41.2
Yes (please describe) 30.4 30.8 35.3

2.2 Regional Strategic Positioning Analysis

Analysis completed on 2026-02-27
Based on 55 unique institutional responses
Duplicates removed: ADEMA entries and University of Georgia duplicate

Note on Data

Minor differences exist in some regional percentages in this report relative to the submitted manuscript, reflecting small differences in regional sample sizes following post-hoc correction of institutional assignments. The submitted manuscript values (Europe n=25, North America n=13, Other Regions n=17) take precedence.

Report Authors

Michael Crowe, BSc, BDentSc, PhD (Dublin Dental University Hospital / Trinity College Dublin) Riva Touger-Decker, PhD, RDN (Rutgers School of Health Professions / Rutgers School of Dental Medicine) Teresa A. Marshall, PhD, RDN (University of Iowa)

How to Cite This Report

Crowe M, Touger-Decker R, Marshall TA (2026). Global Dental School Nutrition Education Survey: Regional Companion Analysis Report. ADEE Community of Practice in Nutrition. Prepared for internal COP circulation pending peer review of the related manuscript.

Acknowledgements

This report was produced on behalf of the ADEE Community of Practice in Nutrition. Full COP membership: Michael Crowe, Riva Touger-Decker, Teresa A. Marshall, Patricia Correia, Claire McEvoy, Ruxandra Sfeatcu, Domenico Dalessandri, Nora Lopez Safont, and Aneta Lazarova. We thank all participating dental schools for their contribution to the survey.